Clinical Evaluation of HW005 Ventricular Assist System for the Treatment of Advanced Heart Failure in Japan

Inclusion Criteria:

1. Patients with irreversible end-stage heart failure of New York Heart Association (NYHA) class III or IV and a history of class IV who are eligible for hearttransplantation.

2. Patients who are dependent on medication of inotropes or intra-aortic balloon pump (IABP).

3. Body Surface Area (BSA) ≥1.2 m2. In addition other factors may be taken intoconsideration, including chest size, abdominal fat (lack of abdominal fat may precludea pump pocket) and any other physical characteristics that might be benefited by anintra-pericardial pump in a small person.

4. Patients who are aged less than 65 years of age.

5. Patients must be able to understand the limits and complications associated with theHW005 Ventricular Assist System.

6. Female patients of childbearing potential must agree on contraception for the durationof the study.

7. The patient or the legal representative has signed the informed consent form.

Exclusion Criteria:

1. Severe illness other than heart disease which would exclude cardiac transplantation.

2. Inadequate family/social support.

3. Active, uncontrolled infection despite appropriate antibiotic, antiviral or antifungaltreatment.

4. Existence of any ongoing mechanical circulatory support (MCS) other than an IABP.

5. Prior cardiac transplant or cardiomyoplasty.

6. Acute myocardial infarction within 14 days of implant.

7. Uncorrected thrombocytopenia or generalized coagulopathy.

8. Intolerance to anticoagulant or antiplatelet therapies or any other peri- orpostoperative therapy that the investigator may administer based upon the patient'shealth status.

9. Patients for whom the use of a left ventricular assist device (LVAD) iscontraindicated due to an ongoing aortic/cardiac aneurysm, intraventricular septumrupture and/or use of a mechanical heart valve.

10. Etiology of heart failure is due to, or associated with, uncorrected thyroid disease,obstructive cardiomyopathy, pericardial disease, amyloidosis, active myocarditis orrestrictive cardiomyopathy.

11. Patients with irreversible hepatic dysfunction.

12. Patients with irreversible renal dysfunction.

13. Pregnancy.

14. Patients with serious chronic obstructive pulmonary disease (COPD) (Forced ExpiratoryVolume in the first second (FEV1) < 50%).

15. Pulmonary vascular resistance is unresponsive (fixed) to pharmacologic manipulation asdemonstrated by a pulmonary artery systolic pressure exceeding 60mmHg in conjunctionwith any one of the two following variables:

• Pulmonary vascular resistance is greater than 6 Woods Units or

• Transpulmonary gradient exceeds 15 mmHg

16. Cardiothoracic surgery within 14 days of implantation.

17. Peripheral vascular disease with rest pain or ischemic ulcers of the extremities.

18. Pulmonary embolus within three weeks of enrollment as documented by computedtomography (CT) scan or nuclear scan.

19. Patients have moderate to severe aortic insufficiency without plans for correctionduring pump implantation surgery. Correction may include aortic valve repair at thetime of implant.

20. The patient who has advanced calcification in the ascending aorta and/or thedescending aorta.

21. Serious right heart failure as defined by the anticipated need for right ventricularassist device (RVAD) support or extracorporeal membrane oxygenation (ECMO) at the timeof screening.

22. Patients with severe central nervous system disorder or severe cerebral vasculardisorder.

23. Patients with a history of drug intoxication, alcohol dependence.

24. Patients unwilling or unable to comply with study requirements.

25. Patients who refuse transfusion.

26. Patients who in the investigator judgement are deemed to be unsuitable as a subject.

27. Patients who are participating in another clinical trial involving investigationaldrugs or devices.